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Biomedical subjects

F Codère

Publications and source records attributed to F Codère.

At least 37 records · Page 2Linked to original sources
PubMed1993

Effect of a topical anesthetic cream (EMLA) in reducing pain caused by infiltration of local anesthetic in eyelid surgery.

EMLA (eutectic mixture of local anesthetics) cream is a topical formulation of a mixture of lidocaine and prilocaine. It has been used to achieve local analgesia after application under an occlusive dressing. We carried out a double-blind randomized controlled clinical trial to assess the effect of 5% EMLA (25 mg/mL of lidocaine and of prilocaine) in reducing the pain caused by infiltration of local anesthetic in eyelid surgery. Pain was assessed by means of a modified visual analogue scale ranging from 0 (no pain) to 10 (excruciating pain) in 25 consecutive patients (average age 65 years) undergoing bilateral eyelid surgery. Clinical significance was defined as a difference in pain scores of 3 or more between EMLA and placebo. The mean pain scores for EMLA and placebo were 3.1 and 4.0 respectively, a nonsignificant difference. The EMLA preparation was found not to be clinically effective in reducing pain caused by infiltration of local anesthetic in eyelid surgery.

Aged↗
PubMed1992

Orbital decompression for Graves' disease: exposure through a modified blepharoplasty incision.

A "transorbital" three-wall decompression through a modified blepharoplasty incision was used to treat 19 orbits for either cosmetic disfigurement or optic neuropathy. In the 14 orbits with disfigurement, surgical retroplacement averaged 5.2 mm; vision improved to 20/40 or better in four of five eyes with optic neuropathy. Complications attributed to the surgery included: acquired strabismus (two transient, one permanent) and infraorbital hypesthesia (one transient, one permanent). This technique's advantages are: 1) a single incision with wide exposure, 2) a low incidence of permanent strabismus, 3) a lateral orbital rim and canthal tendon preservation, and 4) a large reduction in proptosis.

Adult↗
PubMed1991

Upper eyelid movements measured with a search coil during blinks and vertical saccades.

Upper eyelid movements were recorded in nine human subjects by mounting a miniature coil of wire directly on the eyelid and subjecting the search coil to a vertically directed alternating magnetic field. The metrics of blinks and lid movements accompanying saccades were described by "main sequence" relationships, linking maximum velocity to amplitude and duration to amplitude. In general, lid movements were faster than those reported previously in the literature, but there was considerable intersubject variability. On average, the main sequence relationships for blinks were independent of either starting lid position or whether the blinks were generated spontaneously, reflexively, or voluntarily. For the down phase of the average blink, both the maximum velocity and duration increased almost linearly with amplitude. The maximum velocity of the down phase was faster than that of the up phase. For lid movements accompanying vertical saccades, the maximum velocities in the up and down directions were similar and increased nonlinearly with amplitude, saturating at about 120 mm/sec (approximately 450 degrees/sec). Duration increased approximately linearly with amplitude. The down phases of blinks were much faster than those of saccade-related lid movements. By comparison, the maximum velocities of the up phase of blinks and of saccade-related lid movements were almost equal. The large intersubject variability suggests caution when using normative data to interpret abnormal lid motion for clinical purposes.

Adult↗
PubMed1991

Streptococcal lid necrosis in previously healthy children.

Fulminant preseptal eyelid cellulitis developed in two previously healthy children, aged 17 months and 8 years, following minor trauma. Despite appropriate intravenous antibiotic therapy, lid necrosis with ulceration developed in both patients. In both cases group A beta-hemolytic Streptococcus was the causative agent. Spontaneous granulation of the ulcerated areas resulted in cicatricial defects, which in one case may require surgical correction. Neither child had a past history of susceptibility to infection. Group A beta-hemolytic Streptococcus has been known to cause lid gangrene, but almost all previously documented cases occurred in debilitated or elderly patients.

Anti-Bacterial Agents↗
PubMed1991

Orbital volume augmentation with adjustable prefabricated methylmethacrylate subperiosteal implants.

Prefabricated right and left subperiosteal implants were used in nine anophthalmic sockets to correct superior sulcus deformities. The advantages of these implants include increased stability, easy insertion under direct visualization and the possibility of easy retrieval if necessary, and custom modification for volume and shape intraoperatively, with the addition of methylmethacrylate. There were no extrusions, implant migrations, or infections. Complications included mild undercorrection, upper eyelid blepharoptosis, and transient ectropion.

Eye Enucleation↗
PubMed1990

Immunoblastic T-cell lymphoma presenting as an eyelid tumor.

A 59-year-old white man presented with an ulcerating mass of the left upper eyelid of 6 months' duration. A biopsy specimen of the tumor was diagnosed as an immunoblastic T-cell malignant lymphoma. The lesion completely regressed after 4000 cGy of cobalt-60 radiation therapy. In the ensuing 33 months, multiple, widespread skin nodules of the same neoplasm developed including a right upper eyelid tumor. To the authors' knowledge, this is the first reported case of an immunoblastic T-cell lymphoma initially manifesting as an eyelid neoplasm.

Biopsy↗
PubMed1988

Carbon dioxide laser treatment of the conjunctiva and the cornea.

Carbon dioxide (CO2) laser treatment was applied to the cornea and conjunctiva of 16 eyes from eight young pigs at power levels of 2.5 to 20.0 W, an exposure time of 0.1 seconds and different numbers of overlapping burns. Four animals were euthanatized at 30 minutes, one at 36 hours and three from 18 to 21 days after the treatment. Nitrous oxide (N2O) cryotherapy also was applied in a double freeze-thaw fashion to three of the eyes to compare the effects of the CO2 laser and cryotherapy at each of the time intervals. Epithelial destruction was achieved with CO2 laser power levels of 5.0 W and one or more superimposed burns. At 5.0 W, Bowman's membrane was destroyed while the conjunctival substantia propria protected the underlying sclera. The anterior chamber reaction was minimal and appeared to be less intense than with cryotherapy after 36 hours. At high energy levels (20.0 W), corneal and scleral perforation occurred. Furthermore, we have treated five human patients with the CO2 laser for bulbar conjunctival epithelial proliferative disorders. Minimal scarring occurred and local control of the disease was obtained in four patients. The CO2 laser may offer advantages over other modalities of treatment for bulbar conjunctival epithelial disorders. Its use is not recommended for lesions of the cornea and forniceal or palpebral conjunctiva.

Adult↗
PubMed1988

Mucinous eccrine sweat gland adenocarcinoma of the eyelid.

A firm, slow-growing cystic mass of the left upper eyelid developed in a 73-year-old man 5 years after a clinically diagnosed "sebaceous cyst" at the same site had been incised and drained. Histopathological examination disclosed a primary mucinous adenocarcinoma of eccrine sweat gland origin. The patient had no recurrence after 3.5 years of follow-up. Histochemical demonstration of sialomucin differentiates mucinous sweat gland carcinoma from other mucus-secreting adenocarcinomas, such as those arising from lacrimal gland tissue. Enzymatic histochemical analyses or ultrastructural studies are needed to distinguish between mucinous adenocarcinomas of eccrine origin and those of apocrine origin.

Adenocarcinoma, Mucinous↗
PubMed1987

Pyogenic granuloma on a dermis fat graft in acquired anophthalmic orbits.

We treated exposure of the orbital implant with a dermis fat graft in two patients with an acquired anophthalmic orbit. During the first six postoperative months, a large polypoid tumor of the conjunctiva developed over the grafted tissue in each patient. Histologic examination of both lesions disclosed a pyogenic granuloma.

Adipose Tissue↗
PubMed1987

Treatment of blepharospasm with medication, surgery and type A botulinum toxin.

A total of 39 patients with essential blepharospasm and 2 patients with hemifacial spasm were treated with one or more forms of therapy. All patients underwent neurologic and ophthalmic assessment to rule out ocular causes of blepharospasm. Thirty-six patients were given a trial of various medications. Only one patient was successfully treated: her condition was markedly improved with pimozide after benztropine mesylate, clonazepam and amantadine hydrochloride had failed to help. Patients who did not respond to drug therapy were offered the option of undergoing eyebrow-eyelid muscle stripping surgery. The six patients who underwent surgery showed considerable improvement; however, side effects such as frontal anesthesia, exposure keratitis, lagophthalmus, scarring and eyelid malposition occurred, and three of the six had residual spasm. At this point type A botulinum toxin became available. A total of 27 patients (26 who did not respond to drug therapy, including the 3 with residual spasm after surgery, and 1 previously untreated patient) received type A botulinum toxin injections. Most experienced rapid relief from their spasms. The beneficial effects lasted weeks to months, and there were no major side effects. Treatment with type A botulinum toxin appears to be a safe and effective means of temporarily relieving blepharospasm. The long-term results with repeated injections are yet to be determined.

Baclofen↗
PubMed1987

Laser therapy of conjunctival papillomas.

Carbon dioxide (CO2) laser therapy was successfully used in the treatment of recurrent conjunctival papillomas in a 40-year-old man. Surgical excision, cryotherapy and immunotherapy with transfer factor and dinitrochlorobenzene had all been unsuccessful in eradicating the lesions. CO2 laser therapy should be considered as an alternative treatment for conjunctival papillomas refractory to other forms of therapy.

Adult↗
PubMed1985

Sebaceous carcinoma of the eyelid masquerading as superior limbic keratoconjunctivitis.

A 49-year-old woman had been treated for 18 months for superior limbic keratoconjunctivitis of the right eye. Pathologic examination of a biopsy specimen of the superior perilimbal conjunctiva disclosed intraepithelial carcinoma of sebaceous gland origin. Because of the extensive involvement of the conjunctival epithelium by tumor, a subtotal orbital exenteration was performed. To our knowledge, this is the first report of sebaceous carcinoma masquerading as superior limbic keratoconjunctivitis.

Adenocarcinoma↗
PubMed1984

Lacrimal drainage system inflammatory masses from retained silicone tubing.

In two cases studied we found inflammatory masses of the lacrimal system associated with retained silicone material. We saw the first patient two years after a failed dacryocystorhinostomy. A mass of the superior punctum mimicking a lacrimal sac or canalicular neoplasm consisted of chronic granulomatous inflammation centered around retained silicone tubing. In the second patient, a foreign body giant cell inflammatory reaction occurred in the lacrimal sac in which there were retained knots of silicone tubing. We believed the inflammation in these patients to be caused by the knots and the cut ends of the silicone tubing present in the lacrimal drainage system.

Aged↗
PubMed1983

Necrobiotic xanthogranuloma of the eyelid.

Necrobiotic xanthogranuloma with paraproteinemia is characterized by multiple nodules or plaques that involve the periorbital area along with other parts of the body. A dysproteinemia due to an IgG paraprotein is associated with the condition; low serum complement, cryoglobulinemia, leukopenia, and hyperlipemia are also sometimes seen. Multiple myeloma is present in some cases. Two cases of necrobiotic xanthogranuloma with IgG monoclonal gammopathy were seen. Both initially had ocular symptoms and in the second case, the ocular manifestations have dominated the clinical picture. Histologically, these granulomas are characterized by collagen necrobiosis and by the presence of many foamy histiocytes and Touton giant cells. Because necrobiotic xanthogranuloma with monoclonal gammopathy frequently has prominent manifestations in the orbital region, may result in dysfunction of the eyelids or extraocular muscles, and is associated with potentially life-threatening systemic conditions, its recognition by the ophthalmologist is important.

Dysgammaglobulinemia↗
PubMed1983

Bilateral blindness in temporal arteritis with skip areas.

A 73-year-old woman received systemic corticosteroids for suspected temporal arteritis after blindness developed in the right eye during the previous day. Because a right temporal artery biopsy specimen was reported as normal, a diagnosis of arteriosclerotic ischemic optic neuropathy was made and the corticosteroid therapy was discontinued. Two weeks later the patient rapidly lost vision in her left eye. A left temporal artery biopsy specimen showed granulomatous arteritis adjacent to normal artery (skip area). Deeper sections of the original right temporal artery biopsy specimen also demonstrated a small focus of granulomatous arteritis adjacent to normal artery. In patients with suspected temporal arteritis, numerous step sections of a long segment of temporal artery should be examined; if the results are normal, the contralateral temporal artery should be studied. A nonspecific inflammatory reaction within or adjacent to the artery should alert the pathologist to the possible presence of a nearby focus of granulomatous arteritis.

Aged↗
PubMed1982

Bilateral Candida albicans dacryocystitis with facial cellulitis.

Candida albicans rarely infects the lacrimal drainage system. This paper describes a case of bilateral C. albicans dacryocystitis following midfacial trauma. The patient presented with recurrent facial cellulitis and a fistula opening onto the cheek. The condition was controlled only after bilateral dacryocystorhinostomy along with amphotericin B therapy. This appears to be the first reported case in which the lacrimal sacs acted as a reservoir for microorganisms causing recurrent facial cellulitis.

Aged↗